Prevalence, treatment and control of dyslipidaemia in Switzerland: still a long way to go.

BACKGROUND: There is little information regarding the prevalence and management of dyslipidaemia in Switzerland. DESIGN: Cross-sectional population-based study of 3238 women and 2846 men aged 35-75. METHODS: Dyslipidaemia prevalence, treatment and control were defined according to PROCAM guidelines adapted to Switzerland. RESULTS: About 29% of the overall sample presented with dyslipidaemia, of which 39% were treated and 58% of those treated were controlled. Among the 710 patients with personal history of cardiovascular disease (CVD) and/or diabetes, 632 (89%) presented with dyslipidaemia, of which 278 (44%) and 134 (21%) patients were treated and adequately controlled, respectively. On multivariate analysis, hypolipidaemic drug treatment was positively related with age and body mass index (P for trend <0.001), and negatively related with smoking status (P for trend <0.002), whereas personal history of CVD and/or diabetes had no effect [odds ratio (OR)=1.12, 95% confidence interval (CI): 0.90-1.38]. Adequate control of lipid levels was negatively related with female sex (OR=0.65, 95% CI: 0.45-0.94) and personal history of CVD and/or diabetes (OR=0.42, 95% CI: 0.30-0.59). When personal history of CVD and/or diabetes was replaced by PROCAM risk categories, patients in the highest risk were also less well controlled. CONCLUSION: In this population-based study, one-third of the participants was dyslipidaemic, but less than half was treated and only one-fifth was adequately controlled. The low treatment and control levels among individuals at high risk for CVD calls for a better application of recommendations regarding personal preventive measures.

Genetic dissection of sodium and potassium transport along the aldosterone-sensitive distal nephron: Importance in the control of blood pressure and hypertension.

In this review, we discuss genetic evidence supporting Guyton's hypothesis stating that blood pressure control is critically depending on fluid handling by the kidney. The review is focused on the genetic dissection of sodium and potassium transport in the distal nephron and the collecting duct that are the most important sites for the control of sodium and potassium balance by aldosterone and angiotensin II. Thanks to the study of Mendelian forms of hypertension and their corresponding transgenic mouse models, three main classes of diuretic receptors (furosemide, thiazide, amiloride) and the main components of the aldosterone- and angiotensin-dependent signaling pathways were molecularly identified over the past 20years. This will allow to design rational strategies for the treatment of hypertension and for the development of the next generation of diuretics.

Integració de la posició GPS per fer el control del moviment d'un robot

L’objectiu d’aquest treball és fer un estudi dels diferents tipus de sistemes de posicionament global que hi ha en el mercat, elegir un mòdul receptor assequible per poder analitzar-lo i veure si disposa de les característiques adequades per integrar-lo en un robot autònom d’exploració del projecte Sant Bernardo. S’hauran de fer les anàlisis de la precisió del mòdul en les diferents direccions cardinals, es a dir Nord, Sud, Est, Oest i altura i veure la diferència d’error que hi ha en cada una, veure si la precisió varia molt en diferents situacions, com en cel obert, en sotabosc, costat i interior edificis. A més a més s’haurà de mirar la repetibilitat, la diferencia d’error amb diferentnombre de satèl•lits connectats i si disposa de suficient velocitat de processat per a podar corregir la posició del robot en moviment. Un cop analitzades les característiques del mòdul receptor elegit, es decidirà si aquest ésadequat per fer les correccions de posició del robot, o s’haurà d’adquirir un mòdul de característiques superiors i per tant molt més car per a dura a terme adequadament la correcció de la posició

Disseny i implementació de la base de dades d'un sistema de control energètic

Aportació d'una proposta sobre el disseny d'una base de dades que serveixi de magatzem d'informació per a una aplicació que permeti la generació de dades estadístiques sobre l'ús de l'energia.

Analysis and Design of a secure WLAN solution for Cobre Las Cruces

Cobre Las Cruces is a renowned copper mining company located in Sevilla, with unexpected problems in wireless communications that have a direct affectation in production. Therefore, the main goals are to improve the WiFi infrastructure, to secure it and to detect and prevent from attacks and from the installation of rogue (and non-authorized) APs. All of that integrated with the current ICT infrastructure.This project has been divided into four phases, although only two of them have been included into the TFC; they are the analysis of the current situation and the design of a WLAN solution.Once the analysis part was finished, some weaknesses were detected. Subjects such as lack of connectivity and control, ignorance about installed WiFi devices and their localization and state and, by and large, the use of weak security mechanisms were some of the problems found. Additionally, due to the fact that the working area became larger and new WiFi infrastructures were added, the first phase took more time than expected.As a result of the detailed analysis, some goals were defined to solve and it was designed a centralized approach able to cope with them. A solution based on 802.11i and 802.1x protocols, digital certificates, a probe system running as IDS/IPS and ligthweight APs in conjunction with a Wireless LAN Controller are the main features.

Intrauterine exposure to carbamazepine and specific congenital malformations: systematic review and case-control study.

OBJECTIVE: To identify specific major congenital malformations associated with use of carbamazepine in the first trimester of pregnancy. DESIGN: A review of all published cohort studies to identify key indications and a population based case-control study to test these indications. SETTING: Review of PubMed, Web of Science, and Embase for papers about carbamazepine exposure in the first trimester of pregnancy and specific malformations, and the EUROCAT Antiepileptic Study Database, including data from 19 European population based congenital anomaly registries, 1995-2005. PARTICIPANTS: The literature review covered eight cohort studies of 2680 pregnancies with carbamazepine monotherapy exposure, and the EUROCAT dataset included 98 075 registrations of malformations covering over 3.8 million births. MAIN OUTCOME MEASURES: Overall prevalence for a major congenital malformation after exposure to carbamazepine monotherapy in the first trimester. Odds ratios for malformations with exposure to carbamazepine among cases (five types of malformation identified in the literature review) compared with two groups of controls: other non-chromosomal registrations of malformations and chromosomal syndromes. RESULTS: The literature review yielded an overall prevalence for a major congenital malformation of 3.3% (95% confidence interval 2.7 to 4.2) after exposure to carbamazepine monotherapy in the first trimester. In 131 registrations of malformations, the fetus had been exposed to carbamazepine monotherapy. Spina bifida was the only specific major congenital malformation significantly associated with exposure to carbamazepine monotherapy (odds ratio 2.6 (95% confidence interval 1.2 to 5.3) compared with no antiepileptic drug), but the risk was smaller for carbamazepine than for valproic acid (0.2, 0.1 to 0.6). There was no evidence for an association with total anomalous pulmonary venous return (no cases with carbamazepine exposure), cleft lip (with or without palate) (0.2, 0.0 to 1.3), diaphragmatic hernia (0.9, 0.1 to 6.6), or hypospadias (0.7, 0.3 to 1.6) compared with no exposure to antiepileptic drugs. Further exploratory analysis suggested a higher risk of single ventricle and atrioventricular septal defect. CONCLUSION: Carbamazepine teratogenicity is relatively specific to spina bifida, though the risk is less than with valproic acid. Despite the large dataset, there was not enough power to detect moderate risks for some rare major congenital malformations.

Design and evaluation of a panel os single-nucleotide polymorphisms in microRNA genomic regions for association studies in human disease

MicroRNAs (miRNA) are recognized posttranscriptional gene repressors involved in the control of almost every biological process. Allelic variants in these regions may be an important source of phenotypic diversity and contribute to disease susceptibility. We analyzed the genomic organization of 325 human miRNAs (release 7.1, miRBase) to construct a panel of 768 single-nucleotide polymorphisms (SNPs) covering approximately 1 Mb of genomic DNA, including 131 isolated miRNAs (40%) and 194 miRNAs arranged in 48 miRNA clusters, as well as their 5-kb flanking regions. Of these miRNAs, 37% were inside known protein-coding genes, which were significantly associated with biological functions regarding neurological, psychological or nutritional disorders. SNP coverage analysis revealed a lower SNP density in miRNAs compared with the average of the genome, with only 24 SNPs located in the 325 miRNAs studied. Further genotyping of 340 unrelated Spanish individuals showed that more than half of the SNPs in miRNAs were either rare or monomorphic, in agreement with the reported selective constraint on human miRNAs. A comparison of the minor allele frequencies between Spanish and HapMap population samples confirmed the applicability of this SNP panel to the study of complex disorders among the Spanish population, and revealed two miRNA regions, hsa-mir-26a-2 in the CTDSP2 gene and hsa-mir-128-1 in the R3HDM1 gene, showing geographical allelic frequency variation among the four HapMap populations, probably because of differences in natural selection. The designed miRNA SNP panel could help to identify still hidden links between miRNAs and human disease.

Attitudes of detainees and prison staff towards tobacco control policy in Switzerland: a qualitative interview study.

PURPOSE: To explore detainees and staff's attitudes towards tobacco use, in order to assist prison administrators to develop an ethically acceptable tobacco control policy based on stakeholders' opinion. DESIGN: Qualitative study based on in-depth semi-structured interviews with 31 prisoners and 27 staff prior (T1) and after the implementation (T2) of a new smoke-free regulation (2009) in a Swiss male post-trial prison consisting of 120 detainees and 120 employees. RESULTS: At T1, smoking was allowed in common indoor rooms and most working places. Both groups of participants expressed the need for a more uniform and stricter regulation, with general opposition towards a total smoking ban. Expressed fears and difficulties regarding a stricter regulation were increased stress on detainees and strain on staff, violence, riots, loss of control on detainees, and changes in social life. At T2, participants expressed predominantly satisfaction. They reported reduction in their own tobacco use and a better protection against second-hand smoke. However, enforcement was incomplete. The debate was felt as being concentrated on regulation only, leaving aside the subject of tobacco reduction or cessation support. CONCLUSION: Besides an appropriate smoke-free regulation, further developments are necessary in order to have a comprehensive tobacco control policy in prisons.

Guidleines for Removal of Traffic Control Devices in Rural Areas, October 2005

It is commonly regarded that the overuse of traffic control devices desensitizes drivers and leads to disrespect, especially for low-volume secondary roads with limited enforcement. The maintenance of traffic signs is also a tort liability concern, exacerbated by unnecessary signs. The Federal Highway Administration’s (FHWA) Manual on Uniform Traffic Control Devices (MUTCD) and the Institute of Transportation Engineer’s (ITE) Traffic Control Devices Handbook provide guidance for the implementation of STOP signs based on expected compliance with right-of-way rules, provision of through traffic flow, context (proximity to other controlled intersections), speed, sight distance, and crash history. The approach(es) to stop is left to engineering judgment and is usually dependent on traffic volume or functional class/continuity of system. Although presently being considered by the National Committee on Traffic Control Devices, traffic volume itself is not given as a criterion for implementation in the MUTCD. STOP signs have been installed at many locations for various reasons which no longer (or perhaps never) met engineering needs. If in fact the presence of STOP signs does not increase safety, removal should be considered. To date, however, no guidance exists for the removal of STOP signs at two-way stop-controlled intersections. The scope of this research is ultra-low-volume (< 150 daily entering vehicles) unpaved intersections in rural agricultural areas of Iowa, where each of the 99 counties may have as many as 300 or more STOP sign pairs. Overall safety performance is examined as a function of a county excessive use factor, developed specifically for this study and based on various volume ranges and terrain as a proxy for sight distance. Four conclusions are supported: (1) there is no statistical difference in the safety performance of ultra-low-volume stop-controlled and uncontrolled intersections for all drivers or for younger and older drivers (although interestingly, older drivers are underrepresented at both types of intersections); (2) compliance with stop control (as indicated by crash performance) does not appear to be affected by the use or excessive use of STOP signs, even when adjusted for volume and a sight distance proxy; (3) crash performance does not appear to be improved by the liberal use of stop control; (4) safety performance of uncontrolled intersections appears to decline relative to stop-controlled intersections above about 150 daily entering vehicles. Subject to adequate sight distance, traffic professionals may wish to consider removal of control below this threshold. The report concludes with a section on methods and legal considerations for safe removal of stop control.

Trends in prevalence, awareness, treatment and control of hypertension in the Republic of Seychelles (African region) between 1989 and 2013

Objective: We assessed the awareness, treatment and control of hypertension in the Seychelles between 1989 and 2013. In the Seychelles, heath care is free to all inhabitants within a national health system, inclusive all hypertension medications. Design and method: Four surveys were conducted in 1989, 1994, 2004 and 2013 (Seychelles Heart Studies I, II, III and IV) in random samples of the population aged 25-64 (N >1000 and participation rate >75% in each sur acceptance of the program, though no objective index could be calculated. In total, 15% of device measurements were above high normal values and would correspond to either newly diagnosed HNT (second measurement required) or to poorly controlled known HTN. It should be stressed that 53 women without HTN who completed the questionnaire had abnormal BP values, including the 29 women who also contacted the research team. It could be speculated that approximately 2% of women would be first diagnosed with HTN following the completion of the initial phase of the screening program. Conclusions: Hypertension screening in the hair salon setting was proved to be conveniently applicable and well accepted both by owners and by customers and could lead to the new diagnosis of hypertension for 2% of the female clients. Further research is warranted to assess the effectiveness of the program.

Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial.

Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups. This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation. The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population. Trial Registration: (clinicaltrials.gov) NCT00674544.

Predictors of asthma control in everyday clinical practice in Switzerland.

OBJECTIVE: To identify predictors of improved asthma control under conditions of everyday practice in Switzerland. RESEARCH DESIGN AND METHODS: A subgroup of 1380 patients with initially inadequately controlled asthma was defined from a cohort of 1893 asthmatic patients (mean age 45.3 + or - 19.2 years) recruited by 281 office-based physicians who participated in a previously-conducted asthma control survey in Switzerland. Multiple regression techniques were used to identify predictors of improved asthma control, defined as an absolute decrease of 0.5 points or more in the Asthma Control Questionnaire between the baseline (V1) and follow-up visit (V2). RESULTS: Asthma control between V1 and V2 improved in 85.7%. Add-on treatment with montelukast was reported in 82.9% of the patients. Patients with worse asthma control at V1 and patients with good self-reported adherence to therapy had significantly higher chances of improved asthma control (OR = 1.24 and 1.73, 95% CI 1.18-1.29 and 1.20-2.50, respectively). Compared to adding montelukast and continuing the same inhaled corticosteroid/fixed combination (ICS/FC) dose, the addition of montelukast to an increased ICS/FC dose yielded a 4 times higher chance of improved asthma control (OR = 3.84, 95% CI 1.58-9.29). Significantly, withholding montelukast halved the probability of achieving improved asthma control (OR = 0.51, 95% CI = 0.33-078). The probability of improved asthma control was almost 5 times lower among patients in whom FEV(1) was measured compared to those in whom it was not (OR = 0.23, 95% CI = 0.09-0.55). Patients with severe persistent asthma also had a significantly lower probability of improved control (OR = 0.15, 95% CI = 0.07-0.32), as did older patients (OR = 0.98, 95% CI = 0.97-0.99). Subgroup analyses which excluded patients whose asthma may have been misdiagnosed and might in reality have been chronic obstructive pulmonary disease (COPD) showed comparable results. CONCLUSIONS: Under conditions of everyday clinical practice, the addition of montelukast to ICS/FC and good adherence to therapy increased the likelihood of achieving better asthma control at the follow-up visit, while older age and more severe asthma significantly decreased it.

Disseny i implementació d'un sistema de control de registres sanitaris

El treball consisteix en implementar un sistema de BD per donar resposta a la necessitat d'una gran empresa del sector cosmètic que necessita dissenyar un sistema de control dels registres sanitaris que ha de realitzar en els diferents països on es comercialitzen els seus productes.

Control de la derivació de l'aigua de reg de Masjoan

RESUM Masjoan és una masia del segle XII on resideix la família Masferrer des del 1710. Actualment a Masjoan l’activitat principal és el cultiu i venta de plantes ornamentals, i l’explotació forestal per obtenir fusta. Pel que fa a l’aigua, tant per a la realització de l’activitat professional com per al subministrament de la casa, aquesta prové de mines d’aigua natural situades en la finca. L’objectiu d’aquest TFC ha estat dissenyar un sistema autònom per automatitzar el procés de derivació de l’aigua procedent d’una mina, i d’aquesta manera aprofitar millor els recursos naturals dels que és disposa. El desenvolupament d’aquest sistema, comprèn la selecció i configuració de sensors i actuadors, el disseny del circuit amb la realització de la placa, el disseny del sistema d’alimentació autònom, el software que controla el sistema, i dimensionar la resta d’elements de la instal•lació. Tot el sistema està controlat per un microcontrolador PIC16F876 i alimentat per un mòdul solar de 4W. En el disseny s’ha procurat, sobredimencionar les diferents etapes per possibles ampliacions o modificacions del sistema i que el circuit procures optimitzar el consum d’energia. Com a conclusions cal dir que s’han assolit els objectius proposats amb èxit. S’ha aconseguit un disseny funcional i estable que actualment es troba en funcionament.

Projecte executiu d'una instal·lació de climatització i control d'un habitatge unifamiliar

Moltes vegades l’usuari d’una instal•lació de climatització o calefacció, no dóna la suficient importància al sistema que l’hi ha de proporcionar un millor confort amb el màxim rendiment. Aquest confort és un factor determinant, entre molts d’altres, de la “qualitat de vida”. Mentre que el rendiment és un factor important a nivell econòmic i ecològic. Tot i tenir prevalença els aspectes d’estalvi energètic, aquests no impliquen haver de renunciar a un confort tèrmic i a un estalvi econòmic. Un dels aspectes que es centra el projecte és promoure l’ús racional de les fonts energètiques (solar, biomassa) per a la correcta climatització dels habitatges. El projecte es desenvolupa en l’àmbit domèstic, concretament correspon a un habitatge unifamiliar. Aquest està situat a la població de Roda de Ter, província de Barcelona. L’objectiu principal del projecte és l’elecció del sistema de climatització i el seu dimensionament, per tal de donar el màxim confort als usuaris que habitin a la vivenda. Criteris ambientals i eficients han estat objecte a considerar pel disseny constructiu de l’habitatge. Una de les mesures importants presses en el projecte, ha estat l’elecció de les diferents parts que formen la instal•lació de climatització. Es fa referència als aïllaments dels tancaments, el sistema solar de recolzament, equips de producció de fred i calor, entre d’altres. En el projecte, s’ha dut a terme un estudi dels diferents tancaments de l’habitatge, tot determinat per a cada un d’ells, el seu coeficient de transmissió tèrmica. Per seleccionar l’equipament més adequat s’ha partit de les condicions climatològiques del municipi de Roda de Ter i s’ha realitzat el càlcul de les necessitats tèrmiques de l’edifici. L’habitatge incorpora una instal•lació de captació solar tèrmica. Aquesta aportarà un suport energètic a tot el sistema de producció de calor, ja sigui per la producció d’aigua calenta sanitària com per el calefactat de la vivenda. La col•locació dels panells a la façana sud tindrà una doble funció: a més de proporcionar energia solar tèrmica, serviran d’elements de protecció solar en la temporada d’estiu. La caldera usada per donar recolzament tèrmic utilitzarà com a combustible el “pellet”. El “pellet” és un tipus de biomassa llenyosa que consta d’un derivat de la fusta en format granulat. Es defineix i es detalla el consum energètic en biomassa, electricitat i cost econòmic anual que ocasionarà la instal.lació dissenyada. El sistema de terra radiant adoptat permetrà el refrescament en èpoques estivals i el calefactat en èpoques hivernals. Aquest donarà el confort tèrmic necessari a cada estança de l’habitatge. En el projecte també es marquen les pautes bàsiques pel control de la instal•lació solar així com el control dels grups de bombament i la mescla d’aigua del terra radiant.